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Organization

GULFCOAST WELLNESS MANAGEMT GROUP

Active
Parent organization
GULFCOAST WELLNESS MANAGEMT GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
GULFCOAST WELLNESS MANAGEMT GROUP
Authorized official
LAMONT RATCLIFF (DIRECTOR)
(713) 524-4803
Entity
Organization

Contact information

Practice address
2404 CAROLINE ST, HOUSTON, TX 77004-1016
(713) 524-4803
(713) 524-4801
Mailing address
2404 CAROLINE ST, HOUSTON, TX 77004-1016
(713) 524-4803
(713) 524-4801

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
F006483
TX
207Q00000X
Family Medicine Physician
G7943
TX
208100000X
Physical Medicine & Rehabilitation Physician
G7943
TX
2085R0202X
Diagnostic Radiology Physician
G7943
TX
208D00000X
General Practice Physician
G7943
TX
302R00000X
Health Maintenance Organization
AM0871776
TX

Other

Enumeration date
07/10/2007
Last updated
11/11/2008
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